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 CONCEPT
The feverish convulsions are the convulsions that take place during the episodes of high fever.
INCIDENCE
- They affect 1-5 % of the population.
- They are associated with a feverish picture, but without infection evidence intracraneal.
- There exists a genetic predisposition to endure them.
- The presentation age is between 6 months and 5 years of age, 55 % of the cases during the second year of life.
- Generalized in 80-90 % of the cases.
- Brief, with a minor duration to 15 minutes.
- In 65 % of the cases it is only, only 13 % of the patients presents two episodes, and 9 % three episodes or more, during the same feverish process. In general, they resort in six months later to the first episode, being more frequent in <of 15 months and patients with familiar precedents.
- The risk of epilepsy later to the feverish convulsions is 2 % at the age of 7 and 7 % at the age of 25.
EVALUATION
- General and neurological exploration, to clarify the origin of the fever and to discard infection of the central nervous system (SNC). In some cases there can be necessary a lumbar puncture (extraction of spinal liquid for his analysis).
- Electroencephalogram (E.E.G). It is not definitely necessary to realize E.E.G. after the only convulsion episode. In case of practising it, at least two weeks must be realized after the episode. It has no value predictivo, although there exists the habit of doing one and later an annual control.
TREATMENT AND PREVENTION
Control of the fever. With medicines (Paracetamol, Ibuprofeno, Aspirin ®, etc) and physical means (baths with lukewarm water, application of cloths or compresses dampened in lukewarm water on the body). Prophylactic treatment of new convulsions: it is a controversial topic and there is no clear evidence of which it diminishes the epilepsy risk, although if he seems to prepare the recurrencias of the feverish crises. Diverse alternatives exist, with similar efficacy (12 to 15 % of therapeutic defeats in all the cases):
- Diazepam. Rectal administration of diazepam, exclusively during the feverish episodes, of prophylactic form every 8 hours. It is discussed by the possibility of serious respiratory depression.
- Phenobarbital. 5 mg / kg / day oral Route of continuous form. It needs periodic level control in blood. It presents side effects on the development neuropsíquico (irritability, transtornos of the sleep, hyperactivity and problems of learning and concentration).
- Acid Valproico. Also it produces side effects (hepatic alterations, hyperactivity, irritability and alterations of the coagulation) the level control Is necessary in blood of periodic form and in the first months of treatment control of the hepatic function.
INDICATIONS OF THE PROPHYLACTIC TREATMENT
- Age lower than 12 months.
- Third episode of feverish convulsion.
- Long convulsion (more than 15 minutes)
- Focal convulsion (not generalized)
- Convulsion appellant in the same feverish process, especially in the first 24 hours.
- Long postcrisis.
- Transitory abnormal neurological exploration or permanently.
The prophylactic treatment is effective as for the prevention of the recurrencias. The duration of the treatment will always be to criterion of the neuropediatra up to two years depués of the last convulsive crisis.
WHAT DOCTOR CAN TREAT ME?
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CONCEPT 
